Call Us

+91 9820083603

Carotid Artery Disease

Assessment of stenosis

Duplex ultrasound

Carotid angiography

  • Intra-arterial angiography is the traditional method of assessing degree of stenosis
  • 4% risk of inducing further neurological event
  • 1% risk of permanent stroke
Carotid Angiography

Magnetic resonance angiography

  • An increasingly used non-invasive technique

Some surgeons will operate on the basis of non-invasive assessments

Magnetic resonance angiography

Medical Management

Surgery for asymptomatic stenosis

Asymptomatic Carotid Atherosclerosis Study

Surgery for symptomatic stenosis

Two large trials have been published

North American Symptomatic Carotid Endarterectomy Trial (NASCET)

European Carotid Surgery Trial (ECST)

Carotid Endarterectomy

This surgery can be performed under general / local anesthesia. If done under general anesthesia a shunt is used to perfuse the brain. Under local anesthesia, as the patient is awake the use of shunt is limited. The plaque from the carotid artery is removed and a patch is sutured to the edges.

Carotid angioplasty

  • Angioplasty (± stent placement) is being used to dilate stenoses
  • No published randomised trials
  • In uncontrolled studies severe stenoses (>70%) have been dilated to < 50%
  • Re-stenosis often occurs and a significant risk of stroke during the procedure

Dr. Pankaj Patel a vascular surgeon has expertise in peripheral vascular diseases, varicose veins and deep vein thrombosis